EFFECTS OF CHILDBEARING ON GLUCOSE-TOLERANCE AND NIDDM PREVALENCE
EFFECTS OF CHILDBEARING ON GLUCOSE-TOLERANCE AND NIDDM PREVALENCE
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DOI：
10.2337/diacare.13.8.848
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发表时间：
1990-08-01
期刊：
影响因子：
16.2
通讯作者：
BARON, AE
中科院分区：
文献类型：
--
作者：
BOYKO, EJ;ALDERMAN, BW;BARON, AE
本研究的目的是评估生育对随后的葡萄糖耐量和非胰岛素依赖型糖尿病 (NIDDM) 患病率的影响。来自美国 64 个不同地点的受试者样本被招募参加第二次全国健康和营养检查调查。使用复杂的调查设计来从每个地点选择受试者的概率样本。总共招募了 4577 名女性，其中 3057 名接受了是否患有糖尿病的临床和实验室评估。根据口服葡萄糖耐量测试的结果或之前医生诊断的糖尿病结合当前使用的降血糖药物的结果，对女性的葡萄糖耐量进行分类。生育率的定义是受访时每位妇女经历的活产次数。空腹血糖随着活产数量的增加而线性增加（系数 0.009，95% 置信区间 [CI] 0.006-0.012），z-h 值也是如此（系数 0.015，95% CI 0.009-0.021）。对年龄、体重指数（BMI）、教育程度和收入进行调整后，显着降低了生育与血浆葡萄糖测量之间的关联程度。当用逻辑回归分析检查与生育相关的 NIDDM 患病率时，随着活产数量的增加，糖尿病患病率显着线性增加（NIDDM 相对患病率，1 名出生 vs. 0 = 1.73，95% CI 1.39-2.15），但对年龄、BMI、教育和收入的调整大大降低了这种关联的程度（NIDDM 相对患病率，1 名出生 vs. 0 = 1.07， 95% CI 0.98-1.17）。这些数据不支持生育在 NIDDM 的后续发展中的作用。
The goal of this study was to estimate the effects of childbearing on subsequent glucose tolerance and non-insulin-dependent diabetes mellitus (NIDDM) prevalence. A sample of subjects from 64 different locations in the United States were recruited for inclusion in the Second National Health and Nutrition Examination Survey. A complex survey design was used to select a probability sample of subjects from each location. A total of 4577 women were recruited, of whom 3057 underwent clinical and laboratory evaluation for the presence of diabetes mellitus. Women were classified as to their glucose tolerance based on the results of an oral glucose tolerance test or previous physician diagnosis of diabetes mellitus combined with current use of hypoglycemic medication. Childbearing was defined as number of live births experienced by each woman at the time of the interview. Fasting plasma glucose increased linearly with increasing number of live births (coefficient 0.009, 95% confidence interval [CI] 0.006-0.012), as did the z-h value (coefficient 0.015, 95% CI 0.009-0.021). Adjustment for age, body mass index (BMI), education, and income substantially reduced the magnitude of the association between childbearing and either plasma glucose measurement. When the prevalence of NIDDM in relation to childbearing was examined with logistic regression analysis, a significant linear increase in diabetes prevalence was seen with increasing number of live births (relative prevalence of NIDDM, 1 birth vs. 0 = 1.73, 95% CI 1.39-2.15), but adjustment for age, BMI, education, and income greatly reduced the magnitude of this association (relative prevalence of NIDDM, 1 birth vs. 0 = 1.07, 95% CI 0.98-1.17). These data do not support a role for childbearing in the subsequent development of NIDDM.